Organization
APPOMATTOX RIVER MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARTER SPALDING (ADMINISTRATOR)
(804) 458-8557
Entity
Organization
Contact information
Practice address
815 W POYTHRESS ST, HOPEWELL, VA 23860-2532
(804) 458-8557
(804) 541-7113
Mailing address
815 W POYTHRESS ST, HOPEWELL, VA 23860-2532
(804) 458-8557
(804) 541-7113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL0045
MEDICARE RAILROAD
VA
Enumeration date
08/08/2006
Last updated
05/02/2011
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